Nothing More to Be Done

Palliative Care Versus Exerimental Therapy in Advanced Cancer

Dados Bibliográficos

ID4516201
AutoresIlana Löwy (0000-0001-6963-0578, Hôpital Necker-Enfants Malades, autor correspondente)
Ano1995
Volume8
Fascículo1
Páginas209-229
Data de publicação1995-01-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoScience in Context (JOURNAL)
Identificadores do periódicoISSN: 0269-8897 • E-ISSN: 1474-0664
EditoraCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0269889700001964
PMID11639655
OpenAlexW2135096402
IdiomaEN
Citações recebidas7
Referências citadas40

The ArgumentPatients suffering from advanced, incurable cancer often receive from their doctors proposals to enroll in a clinical trial of an experimental therapy. Experimental therapies are increasingly perceived not as a highly problematic approach but as a near-standard way to deal with incurable cancer. There are, however, important differences in the diffusion of these therapies in Western countries. The large diffusion of experimental therapies for malignant disease in the United States contrasts with the much more restricted diffusion of these therapies in the United Kingdom. The difference between the two reflects differences in the organization of health care in these countries and distinct patterns of the professionalization of medical oncology in America and in Britain. The high density and great autonomy of medical oncologists in the United States encourages there the diffusion of experimental therapies (regarded by some as expensive and inefficient); the lower density of these specialists in the United Kingdom and their task as consultants and not primary caregivers, favors the choice of more conservative (for some, too conservative) treatments. Theoretically, the decision as to whether patients suffering from advanced, incurable cancer will be steered toward an experimental therapy or toward palliative care depends on the values and beliefs of these patients and their physicians. In practice, however, such choice does not depend exclusively on the individual' cultural background and ethical values, but is also strongly affected by the - culturally conditioned - Professional and institutional structure of medicine

Autonomy · Cancer · Disease · Family medicine · Health care · Nothing · Palliative care · Political science · Professionalization · Biomedical Ethics and Regulation · Ethics in Clinical Research · Law · Medicine · Nursing · Palliative Care and End-of-Life Issues · Internal Medicine